Comparative study on analgesic effect of bupivacaine liposome and ropivacaine on quadratus lumborum block in patients undergoing laparoscopic total hysterectomy

XU Huan-xi; PAN Xiong-xiong; MA Rong; XU Xu; LI Xian-rui; WU Hao

doi:10.11659/jjssx.12E024053

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Comparative study on analgesic effect of bupivacaine liposome and ropivacaine on quadratus lumborum block in patients undergoing laparoscopic total hysterectomy

Clinical Research | 更新时间：2025-10-24

- Comparative study on analgesic effect of bupivacaine liposome and ropivacaine on quadratus lumborum block in patients undergoing laparoscopic total hysterectomy
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 10, Pages: 892-895(2025)
- 作者机构：
  
  1.南京医科大学附属宿迁第一人民医院麻醉与围术期医学科，江苏宿迁 223800
  2.南京医科大学第一附属医院麻醉科，江苏南京 210000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.12E024053
  CLC： R916
- Received：10 December 2024，
  
  Published：25 October 2025
- 稿件说明：
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徐幻浠,潘熊熊,马蓉等.布比卡因脂质体与罗哌卡因腰方肌阻滞在腹腔镜全子宫切除术后的镇痛效果比较[J].局解手术学杂志,2025,34(10):892-895.

XU Huan-xi,PAN Xiong-xiong,MA Rong,et al.Comparative study on analgesic effect of bupivacaine liposome and ropivacaine on quadratus lumborum block in patients undergoing laparoscopic total hysterectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(10):892-895.
徐幻浠,潘熊熊,马蓉等.布比卡因脂质体与罗哌卡因腰方肌阻滞在腹腔镜全子宫切除术后的镇痛效果比较[J].局解手术学杂志,2025,34(10):892-895. DOI： 10.11659/jjssx.12E024053.

XU Huan-xi,PAN Xiong-xiong,MA Rong,et al.Comparative study on analgesic effect of bupivacaine liposome and ropivacaine on quadratus lumborum block in patients undergoing laparoscopic total hysterectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(10):892-895. DOI： 10.11659/jjssx.12E024053.

摘要

目的

明确布比卡因脂质体与罗哌卡因用于腹腔镜全子宫切除患者腰方肌阻滞效果的差异。

方法

选取2023年1月至2024年10月于南京医科大学附属宿迁第一人民医院行腹腔镜全子宫切除的70例患者为研究对象，将患者随机分为对照组和观察组，每组35例。在全身麻醉前，对照组患者给予罗哌卡因腰方肌阻滞，观察组患者给予布比卡因脂质体腰方肌阻滞。对2组患者手术前后一般情况、术后不同时点视觉模拟量表(VAS)评分、补救镇痛情况、术后不同时点简易智能状态检查量表（MMSE）评分、术后康复情况和镇痛不良反应进行比较。

结果

2组患者手术前后一般情况比较，差异均无统计学意义（

0.05）。在术后24 h、48 h和72 h，观察组患者腹部静息VAS评分均明显低于对照组（

0.05）。观察组患者静脉镇痛泵术后首次自控使用

时间明显晚于对照组（

0.05），术后48 h内镇痛泵按压次数和羟考酮补救镇痛率均明显少/低于对照组（

0.05）。在术后24 h、48 h和72 h，观察组患者MMSE评分均明显高于对照组（

0.05）。观察组患者术后下床活动时间和肛门恢复排气时间均显著早于对照组（

0.05）。2组患者的术后镇痛不良反应发生率无统计学差异（

0.05）。

结论

相对于使用罗哌卡因对腹腔镜全子宫切除患者进行腰方肌阻滞，布比卡因脂质体可以提供更长时间的镇痛作用，降低患者对静脉镇痛的依赖，有利于保护患者认知功能，可加快患者康复速度且不增加不良反应发生率。

Abstract

Objective

To clarify the differences in the effects of bupivacaine liposome and ropivacaine on quadratus lumborum block in patients undergoing laparoscopic total hysterectomy.

Methods

A total of 70 patients who underwent laparoscopic total hysterectomy at Suqian First People's Hospital Affiliated to Nanjing Medical University from January 2023 to October 2024 were selected as the research subjects. The patients were randomly divided into the control group and the observation group， with 35 cases in each group. Before general anesthesia，patients of the control group were given ropivacaine quadratus lumborum block， while patients of the observation group were given bupivacaine liposome quadratus lumborum block. The general conditions before and after operation， visual analogue scale （VAS） scores at different time points after operation， rescue analgesia， mini-mental state examination （MMSE） scores at different time points after operation， postoperative rehabilitation and analgesic adverse reactions were compared between the two groups.

Results

There was no statistically significant difference in the general conditions of patients in the two groups before and after the operation （

0.05）.At 24 hours， 48 hours， and 72 hours after surgery， the abdominal resting VAS scores of patients in the observation group were significantly lower than those in the control group （

0.05）.The time of the first self-controlled use of the

intravenous analgesic pump after surgery in the observation group was significantly later than that in the control group（

0.05）.The number of analgesic pump compressions and the rate of oxycodone rescue analgesia in the observation group were significantly fewer/lower than those in the control group within 48 hours after surgery （

0.05）.At 24 hours， 48 hours， and 72 hours after surgery， the MMSE scores of patients in the observation group were significantly higher than those in the control group （

0.05）.The time for patients to get out of bed and move around after surgery and the recovery time of anal exhaust in the observation group were significantly earlier than those in the control group （

0.05）. There was no statistically significant difference in the incidence of postoperative analgesic adverse reactions between the two groups of patients （

0.05）.

Conclusion

Compared with the use of ropivacaine for quadratus lumborum block in patients undergoing laparoscopic total hysterectomy， bupivacaine liposome can provide a longer-lasting analgesic effect， reduce patients' dependence on intravenous analgesia， be conducive to protecting patients' cognitive function， accelerate the recovery of patients without increasing the incidence of adverse reactions.

关键词

Keywords

references

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